Two by Two

CHAPTER 23: No

When Marge was eleven, she and my mom were involved in a car accident.

Back then, my mom was still driving one of those huge, wood-paneled station wagons. Because they were from a different generation, my parents weren’t accustomed to wearing seatbelts, and as a family we rarely did.

Marge liked seatbelts even less than I did. Whereas I simply forgot to put mine on when I hopped in the car-I was still young, remember-Marge deliberately chose not to wear them, because it allowed her more freedom to punch or pinch me whenever the mood struck. Which, I might add, was way too often.

I wasn’t in the car that day, and though I’m not sure how accurate my recollections are, it seems the accident was no fault of my mom’s. She wasn’t speeding, the road wasn’t busy, and she was passing through an intersection while the light was green. Meanwhile, a teenager-probably fiddling with the radio or scarfing down McDonald’s French fries-blew through the red light and broadsided the rear of the station wagon.

While my mom was a little banged up, it was Marge whom everyone was most worried about. The momentum from the crash had thrown her into the side windows, shattering the glass. While she wasn’t unconscious when she arrived at the hospital, she was bleeding and bruised, and had sustained a broken collarbone.

When I entered Marge’s hospital room with my dad, the sight of my sister scared me. At six years old, I didn’t know much about death, or even hospitals. My dad stood over her bed, his expression flat, but I could tell by his posture that he was frightened, which scared me even more. Looking down at my stricken face, he frowned.

“Come see your sister, Russ.”

“I don’t want to,” I can remember saying.

“I don’t care what you want,” he said. “I told you to come here, and you’re going to do what I tell you.”

His tone brooked no argument and I inched toward the bed. Marge’s face was grossly swollen, with deep bruises and multiple stitches, like she’d been sewn back together. She didn’t look like my sister; she didn’t look like anyone. She looked like a monster in a scary movie and the sight of her caused me to burst into tears.

To this day, I wish I hadn’t cried. My dad thought I was crying for Marge and I felt him lay a comforting hand on my shoulder, which made me cry even harder.

But I wasn’t crying for Marge. I was crying for myself, because I was afraid, and over time, I came to despise myself for my reaction.

Some people have courage.

On that day, I learned that I wasn’t one of them.

The doctors didn’t know what was wrong with Marge. Nurses took samples of blood and X-rayed her chest. That was followed by a CAT scan. Three different doctors came to examine her. I watched as a needle was inserted into Marge’s lungs to remove tissue for further examination.

Throughout it all, Marge was the only one who didn’t seem worried. Part of that had to do with the fact that since she’d arrived at the hospital, her coughing had abated. She joked with the doctors and nurses while Liz and my parents looked on with grim concern, and I thought again about how effective my sister was at hiding her fears, even from those who loved her. Meanwhile, in another part of the hospital, tests were being run. I heard the doctor whispering words like pathology and radiology. Biopsy. Oncology.

Liz was clearly worried, but not yet panicked. My parents sat like stones, barely holding it together. And I was upset, because Marge didn’t look good. Her skin had a grayish pallor, which accentuated her weight loss, and I found myself replaying all that I’d seen and the things she’d said over the last few months. The racking cough that never seemed to go away, the soreness in her legs. How exhausted she’d been after her vacation.

My parents and I, Liz and the doctors, were all thinking about the same thing.

The cancer.

But it couldn’t be cancer. Marge couldn’t be that sick. She was my sister and she was only forty years old. A little more than a week ago, she’d gone to a specialist because she wanted to have a baby. She was looking forward to being pregnant. She had her entire life ahead of her.

Marge couldn’t be sick. She didn’t have the cancer.

No.

No, no, no, no, no…

I was thankful that Vivian had taken London to Atlanta, because I don’t know what I would have done with her all day. I spent hours drifting in and out of Marge’s hospital room. When I couldn’t take it anymore, I would pace the parking lot or have coffee in the cafeteria. I called Emily and shared what was going on; I asked her not to come by, but she came anyway.

Marge and Emily had a short but sweet reunion a little before noon, and in the hallway afterward, Emily held me as I shook with fear. She told me that she wanted to see me later, if I was up to it, and I promised that I’d call.

Finally, I called Vivian. When I told her what was going on, she gave a strangled gasp and immediately offered to fly back with London right away. I explained that London was probably better off with her, at least through the weekend. Vivian understood.

“Oh, Russ,” she said quietly, sounding nothing like her usual brisk self. “I’m so sorry.”

“Don’t be sorry yet,” I said, “we don’t know anything for sure.”

I was lying to myself, and both Vivian and I knew it. She was well aware of the history on my mother’s side of the family. As I spoke again, I could hear my voice cracking.

“Do me a favor and don’t say anything to London yet, okay?”

“Of course not. Is there anything I can do? What do you need?”

“Nothing for now,” I said. “Thanks.” Words were becoming hard to form, my thoughts beginning to scatter. “I’ll let you know.”

“Keep me informed, okay?”

“I will,” I promised, and I knew that I would. After all, we were still married.

In the afternoon, while my parents and Liz were visiting the cafeteria, I stayed with Marge. She asked about my work, and at her insistence, I described the ad campaigns I was crafting for my clients. I think she remembered that day in the hospital so long ago, after the auto accident, and could tell how frightened I was. She knew I could speak about work on autopilot, so she kept asking questions, to distract me.

As had become her habit, she asked about Emily and I finally admitted that I’d fallen in love, but wasn’t ready to tell our parents yet. At that, she cracked a grin.

“Too late. Mom and Dad already know.”

“How? I haven’t said anything to them.”

“You didn’t have to,” she said. “When you called Emily on Thanksgiving, the way you felt about her was plain as day. Mom raised her eyebrows while Dad turned to me and said, ‘Already? He’s not even divorced yet.’”

Despite everything, I laughed. That was my dad, all right. “I didn’t realize it was so obvious.”

“Uh-huh,” she said, nodding. “I just wish you hadn’t waited until today to bring her by. I look like hell. You should have had us meet right after Costa Rica, when I was still tan.”

I nodded, struck by how normal Marge sounded.

“My bad.”

“I’d like to meet Bodhi, too. Since I’ve heard so much about him.”

“I’m sure you’ll have a chance.”

She twisted the hospital sheet, winding it tight and letting it unfurl. “I’ve been thinking about baby names,” she said. “I bought one of those books, you know? At work, whenever I’m bored, I look through it. I even started highlighting some of them.”

Baby names? Was she really talking about baby names? I could feel pressure behind my eyes and I struggled to get the words out without my voice cracking. “Any favorites?”

“If it’s a boy, I like Josiah. Elliot. Carter. If it’s a girl, I like Meredith and Alexis. Of course, Liz is going to have her own ideas, but I haven’t spoken to her about it yet. It’s still pretty early in the process, so we have plenty of time to make a decision.”

Plenty of time.

Marge must have heard herself because she looked first toward the clock, then the door of the room, which was propped open. Nurses hurried past, going about their duties as if today were no different than any other day. “I wonder when they’re going to finally let me out of here,” she said. “What’s taking them so long? I’ve been here for hours already. Don’t they know I have things to do?”

When I had no answer to that, Marge sighed. “You know I’m going to be okay, right? I mean, I’m not ignoring what happened this morning, but I don’t feel all that bad. I feel a lot better than I did before I left for Costa Rica, in fact. I probably just picked up some parasite while I was down there. Lord only knows what the sanitary standards are like in those kitchens.”

“We’ll see what the doctors say,” I murmured.

“If you see them, tell them to hurry up. I’d rather not waste my whole weekend here.”

“I will.”

Marge continued to wind and unwind the sheet. “London comes back tomorrow, right?”

“She does. I don’t know what time exactly. Early evening, I’d guess.”

“Why don’t you bring London over for dinner with Liz and me this week? You’ve been so busy lately, we haven’t had time for our normal sit-downs.”

Watching her work the sheet, I could feel my throat tightening again. “Dinner sounds great. But none of that Costa Rican food. What with all the parasites, right?”

“Yeah,” she said, looking right at me. “Trust me when I tell you that you don’t want what I have.”

The day crawled by.

Midafternoon. Late afternoon.

Vivian texted, asking if there was any news. I replied that we were still waiting.

Emily texted, asking how I was doing.

Scared to death, I replied.

As dusk approached, the sky began to cloud over. Marge’s hospital room was bathed in flat gray light, and the TV was tuned to Judge Judy, though on mute. The machine monitoring her vitals beeped steadily. A doctor that we hadn’t met came into the room. Though his demeanor was steady, his expression was grim and I already knew what he was going to tell us. He introduced himself as Dr. Kadam Patel, and he was an oncologist. Over his shoulder, in the hallway, I watched as a young girl in a wheelchair was rolled past the room. In her arms was a stuffed animal, a purple pig.

Just as my mother had dreamed.

I went blank, my mind tuning out almost as soon as he began to speak, but I caught various bits and pieces.

Adenocarcinoma… more common in women than men… more likely to occur in younger people… non-small cell… slower growing than other types of lung cancer, but unfortunately, it’s advanced and the CT scan shows that it has metastasized to other parts of the body… both lungs, lymph nodes, bones and her brain… malignant pericardial effusion… stage IV… incurable.

Incurable…

My mom was the first to let out a cry; the plaintive wail of a mother who knows that her child is dying. Liz followed a moment later and my dad took her in his arms. He said nothing, but his lower lip trembled while he squeezed his eyes shut, as if trying to block out reality. Marge sat unmoving on the bed. Watching her, I felt as though I would topple over but somehow, I remained upright. Marge kept her gaze fixed on the doctor.

“How long do I have?” she asked, and for the first time that day, I heard fear in her voice.

“It’s impossible to say,” Dr. Patel answered. “Though it’s incurable, it’s treatable. Treatment has improved exponentially in the last ten years. It can not only prolong life, it can alleviate some of the symptoms.”

“How long?” Marge demanded. “With treatment?”

“If we had caught it earlier,” Dr. Patel hedged. “Before it had metastasized-”

“But we didn’t,” Marge said, cutting him off.

Dr. Patel stood a bit straighter. “Again, there’s no way to know exactly. You’re young and in good condition, both of which increase life expectancy.”

“I understand that it’s not a question that you want to answer. I also understand that every patient is different, which means you can’t really know for sure. What I want, though, is your best guess.” Marge’s voice made it clear she would not be deterred. “Do you think I have a year?”

The doctor didn’t answer, but his expression was pained.

“Six months?” Marge pressed, and again, the doctor didn’t answer.

“Three?”

“Right now,” Dr. Patel said, “I think it would be best if we start discussing treatment options. It’s critical that we get started right away.”

“I don’t want to discuss treatment,” Marge said. I could hear anger in her voice. “If you think I only have a few months, if you’re telling me it’s incurable, then what’s the point?”

Liz had collected herself enough to wipe her eyes. She moved toward the bed and took Marge’s hand. Lifting it to her mouth, she kissed it. “Baby?” she whispered. “I want to hear what the doctor says about treatment options, okay? I know you’re afraid, but I need to know. Can you listen? For me?”

For the first time, Marge turned from the doctor. The trail of her tear had left a streak on her cheek that the light caught, making it shine.

“Okay,” Marge whispered, and only then, did Marge begin to cry.

Systemic chemotherapy.

Over the next forty minutes, the doctor patiently explained to us his reasoning for the course of treatment he was recommending. Because the cancer was so advanced, because it had spread throughout Marge’s body and reached her brain, there were no real surgical options. Radiation was a possibility, but again, because of the spread, the benefits weren’t worth the costs. Usually, patients were given more time to consider all the pros and cons of chemotherapy-including side effects, and he went over those in detail-but again, because the cancer was so advanced, the doctor strongly recommended that Marge start immediately.

To do that, Marge would need a catheter. When that part was underway, my parents and I left the room to go to the cafeteria. We didn’t speak; instead, we sat in silence, each of us simply trying to process what was happening. I ordered coffee that I didn’t drink, thinking that chemotherapy is essentially poison, and the hope is that the cancer cells are killed before normal cells. Too much poison and the patient dies; too little poison, and the medicine does no good at all.

My sister had already known all this. My parents and I had known all this as well. We had grown up knowing about the cancer. All of us knew about stages and survival rates and possible remission and catheters and side effects.

The cancer, after all, spread not only through human bodies. Sometimes it spread through families, like mine.

Later, I returned to the room, and I took a seat in the chair, watching as the poison began to be administered, killing as it flowed through her system.

I left the hospital when the sky had turned black, and I walked my parents to their car. To me, it seemed like they were shuffling rather than walking, and for the first time, they seemed old. Beaten down and utterly wrung out. I knew because I was feeling the same way.

Liz had asked us if she could be alone with Marge. As soon as she asked, I felt guilty. Lost in my own feelings about Marge, it didn’t occur to me that the two of them needed time together, without an audience.

After watching my parents pull out of the parking lot, I walked slowly to my car. I knew I couldn’t stay at the hospital but I didn’t want to go home. I didn’t want to go anywhere. What I wanted was to be able to rewind, to return to yesterday. Twenty-four hours earlier, I had been having dinner with Emily and looking forward to an evening of laughter.

The stand-ups at the Comedy Zone were good, and although one of the routines had been a bit too profane for my taste, the second comedian was both married and a father, and the humorous stories he related had the sweet ring of familiarity. At one point, I reached for Emily’s hand and when I felt her fingers intertwine with my own, I felt as though I’d come home. This, I remember thinking, is what life is really about. Love and laughter and friendship; happy times spent with those you care about.

As I drove home, yesterday seemed impossibly distant, a different lifetime altogether. The axis of my world had shifted, and like my parents, I’d aged in the last few hours. I’d been hollowed out. And as I squinted through eyes that had gone blurry with tears, I wondered if I would ever feel whole again.

Emily texted to ask if I was still at the hospital, and when I replied that I’d gone home, she said that she was coming over.

She found me on the couch, in a house illuminated by a single lamp in the family room. I hadn’t risen when she’d knocked at the door and she’d let herself in.

“Hey there,” she said, her voice soft. She crossed the room and sat beside me.

“Hi,” I said. “Sorry I didn’t get the door.”

“It’s fine,” she said. “How’s Marge? How are you?”

I didn’t know how to answer and I pinched the bridge of my nose. I didn’t want to cry anymore.

She slipped her arm around me and I leaned into her. Just like earlier that day, she held me close, and we didn’t have to talk at all.

Marge was released from the hospital on Sunday. Though she was weak and nauseated, she wanted to go home and there was no reason to stay at the hospital.

The first dose of poison, after all, had already been administered.

I pushed the wheelchair, my parents trailing behind me. Liz walked beside the wheelchair, clearing a path in the busy hallways. No one we passed cast a second glance in our direction.

It was cold outside. On the way to the hospital, Liz had asked me to swing by their house to get Marge a jacket. She directed me to a key hidden under a rock to the right of the front door.

I had let myself in and rummaged through the foyer closet, trying to find something soft and warm. I finally settled on a long down jacket.

Before going outside, Liz helped Marge stand so she could slip on the jacket. She winced and wobbled, but kept her balance. Liz and my parents set out for the parking lot together, then veered in opposite directions to find their cars.

“I hate hospitals,” Marge said to me. “The only time I’ve ever been in a good mood in a hospital was when London was born.”

“I’m with you,” I said. “That’s it in my book, as well.”

She pulled at her jacket, pinching it closed around her neck. “So roll me outside, would you? Let’s get out of here.”

I did as she asked, feeling a brisk wind nip at my cheeks as soon as we exited the building. The few trees in the parking lot were barren of leaves and the sky was an iron gray.

When Marge spoke again, her voice was so soft I almost missed it. “I’m afraid, Russ,” she whispered.

“I know,” I said. “I am, too.”

“It’s not fair. I never smoked, I hardly ever drank, I ate right. I exercised.” For a moment, she looked like a child again.

I squatted down so I could be at eye level. “You’re right. It’s not fair.”

She met my gaze, then, and barked out a resigned laugh. “This is all Mom’s fault, you know,” she said. “Her and the family genes. Not that I’d ever say that to her. And not that really I blame her. Because I don’t.”

I’d had the identical thought, but hadn’t spoken the words aloud. I knew that my mom was tormented by the same idea, and it was one of the reasons she’d barely spoken while at the hospital. I reached over and took Marge’s hand.

“I feel like crap,” Marge said. “I’ve already decided that I hate chemotherapy. I’ve thrown up four times this morning and now, I don’t feel like I have enough strength to get to the bathroom on my own.”

“I’ll help you,” I said. “I promise.”

“No,” she said, “you won’t.”

“What are you talking about? Of course I will.”

I’d never seen Marge look so sad-Marge, who shrugged off even the biggest losses with pragmatic insouciance. “I know that’s what you think you should do. And I know that you’ll want to.” She gripped my hand. “But I have Liz. And you have London, and your business, and Emily.”

“I could care less about work right now. Emily will understand. And London is in school most of the time.”

Marge didn’t answer right away. When she spoke, it was as if she were returning to a conversation I didn’t know we were having. “Do you know what I admire about you? Among other things?” she said.

“I have no idea.”

“I admire your strength. And your courage.”

“I’m not strong,” I protested. “And I’m not brave.”

“But you are,” she said. “When I look back at the past year, and all you’ve gone through, I’m not sure how you made it. I watched you become the father I always knew you could be. I saw you at your very lowest after Vivian left. And I watched you pull yourself back up. All while launching a business and the struggles that entailed. Not many people could have handled the past six months the way you did. I know for a fact that I couldn’t have.”

“Why are you telling me this?” I asked, uncomprehending.

“Because I’m not going to let you stop doing what you need to do, just because of me. That would break my heart.”

“I’m going to be here for you,” I said. “You can’t talk me out of it.”

“I’m not asking you to abandon me. I’m asking that you continue to live your life. I’m asking you to be strong and brave again. Because London’s not the only one who’s going to need you. Liz is going to need you. Mom and Dad, too. One of you has to be the rock. And while you might not believe it, I know in my heart that you’ve always been the strongest of us all.”